This invention, like other immunoassay techniques, is a process for determining the presence of, or the amount of, antigen in a fluid sample, such as a patient's blood or urine. Unlike other immunoassay techniques, the present invention simplifies the immunoassay procedure by providing a method for obtaining a linear standard curve, particularly in the situation where high concentrations of antigen are to be measured.
An antigen is a substance, usually a protein or carbohydrate, that when introduced into the body stimulates the production of an antibody. One example of an antigen is a foreign substance in the body which causes disease, such as a virus.
Another example of an antigen is a substance which evidences a condition of the body. Such antigens are of diagnostic significance. For example, the presence of the antigen IgE (immunoglobulin E) is indicative of an allergy condition, while the antigen hCG (human Chorionic Gonadotropin) is an indication of pregnancy. The antigen ferritin, an iron containing protein, is usually measured as an indication of one of two conditions: (1) anemia (where ferritin is present in relatively low concentrations); and, (2) iron overload (where ferritin is present in relatively high concentrations). These are just a few exemplars of antigens which are of diagnostic use in immunoassays.
Immunoassay techniques rely upon the formation of a complex between the antigen being assayed and an antibody or antibodies. The antibodies are reagents which are added during the immunoassay procedure. Means are provided whereby the amount of complexed antigen and antibody is detectable. Ordinarily, detection is accomplished through the use of a label. The label may, for example, be a radioactive label, such as I.sup.125, an enzyme label, such as horseradish peroxidase (HRPO), or a fluorescing label, such as fluorescein, although other labelling means are possible. The label is attached to one of the members which form the antigen:antibody complex and is usually detected and/or quantified subsequent to separation of the complexed labelled antigen and antibody from the uncomplexed labelled antigen or antibody.
There are several known methods of immunoassay employing antibodies which are labelled so as to be analytically identifiable. "Sandwich" or "two-site" techniques involve the formation of a complex between the antigen, and two antibodies which bind to two different locations on the surface of the antigen, in such a way that the antigen is said to be "sandwiched" between the two antibodies, as disclosed in U.S. Pat. No. 4,016,143. A convenient method of detecting the amount of antigen:antibody:antigen complex formed in such techniques is to provide a first unlabelled antibody bound to a solid phase support and a second unbound labelled antibody. In this manner, the label becomes bound to the solid support through the antibody:antigen:antibody sandwich, and the labelled complex can readily be isolated. In the standard approach, the amount of label on the solid support is detected and/or quantified, although, in one rarely used variation of the sandwich immunoassay, the amount of label remaining in solution may be measured.
The terms first antibody and second antibody are used herein for the sake of clarity and are not intended to indicate, or limit, the direction of the immunoreaction. For example, the immunoassay can proceed in a forward, fast forward, simultaneous, or reverse mode, as is known in the art. See for example, U.S. Pat. No. 4,376,110. E.g., the antigen can react first with the bound antibody and then with the labelled antibody or vice versa. The reactions can also take place simultaneously. In the case of fast forward and simultaneous assays, only one incubation is used to effect complex formation, while forward and reverse assays require at least two incubations. Pursuant to one or more such incubations, the label becomes attached to the support through the insolubilized antibody:antigen:labelled antibody sandwich. The amount of labelled antibody on the solid support, or the amount remaining in solution, can then be detected.
The sandwich immunoassay has become widely attractive in the clinical and diagnostic testing industry, due to its high degree of specificity. However, with this type of immunoassay, it is often difficult to produce an actual linear standard curve. What is meant by an actual linear standard curve is a standard curve which is relatively linear, i.e., usually about 90-105% linear, as produced within the system itself. This is to be distinguished from a visually linear standard curve, wherein the relative linearity is achieved through mathematical manipulation.
In the particular case of assays where a significant amount of antigen is to be measured, the production of an actual linear standard curve is frequently an impossible task. This is because the antigen, when it is present in significant amount, cannot act as the limiting factor in the reaction system. In contrast, where the antigen of interest is present in sufficiently low quantity, the antigen becomes the rate-limiting factor in the immunoassay, thus naturally creating a pseudo first-order reaction and producing a linear standard curve.
By way of background, chemical reactions can be classified on a kinetic basis, that is, by reaction order, depending on the manner in which the reaction rate is influenced by the concentration of reactants under a given set of conditions. A first-order reaction is one which proceeds at a rate directly proportional to the concentration of one reactant only. The simplest example of a first-order reaction is where the rate of the reaction A.fwdarw.P is exactly proportional to the concentration of A. This is what happens, for example, in the case of isotope decay. An assay based on a first-order reaction will ordinarily produce a linear standard curve.
In a second-order reaction, the reaction rate is proportional to the product of the concentration of two reactants or to the second power of the concentration of a single reactant. An example of the former is the reaction A+B.fwdarw.P. An example of the latter is the reaction 2A.fwdarw.P. An assay based on a second-order reaction, particularly a second-order reaction of the former type, will ordinarily produce a nonlinear standard curve. This is because the reaction rate is dependent on the concentration of more than one reactant. This holds true for third-order reactions, fourth-order reactions, and so forth.
A second-order reaction, such as A+B.fwdarw.P, or, for example, a third-order reaction, such as A+B+C.fwdarw.P, may, under certain circumstances, appear to be a first-order reaction. For example, if the concentration of B and/or C is very high and that of A is very low, the reaction might appear to be first-order, because its rate will be nearly proportional to the concentration of only one reactant, namely, A. In this instance A will act as the rate-limiting factor. Under these particular conditions, the reaction is an apparent or pseudo first-order reaction.
A sandwich immunoassay may generally be regarded as a third-order reaction, represented by the equation: EQU O--Ab.sub.1 +Ag+Ab.sub.2 *.fwdarw.O--Ab.sub.1 --Ag--Ab.sub.2 *
wherein O--Ab.sub.1 is an insolubilized antibody, Ag is the antigen of interest, and Ab.sub.2 * is the labelled antibody that completes the sandwich. In the case of a sandwich immunoassay where the antigen of interest is in very low concentration, the antigen naturally acts as the rate-limiting factor in the overall reaction. Thus, in this limited application, the immunoreaction becomes a pseudo first-order reaction with the reaction rate being nearly proportional to the concentration of the antigen sought to be measured. This enables the production of a linear standard curve.
In broader applications, where the antigen of interest is not present in sufficiently low quantities to naturally act as the rate-limiting factor in the overall immunoreaction, a nonlinear standard curve will result. It would be desirable to also achieve a linear standard curve in sandwich immunoassays of this type for several reasons. Among other things, a linear standard curve enables one to achieve single point calibration which, in turn, results in decreased cost in running the immunoassay as well as increased convenience for the operator. For purposes of single point calibration, a single standard is run alongside of a blank. The standard will yield the single point, while the blank defines the y-intercept of the standard curve. Because the standard curve is a straight line, only two points are necessary to define the curve. A single conversion factor can be calculated from this curve.
In the case of a nonlinear standard curve, an average of five standards will ordinarily have to be run in order to plot the curve. This becomes quite expensive where a new standard curve is prepared for each batch of immunoassays that are run. Moreover, a linear standard curve will give more accurate results than a nonlinear standard curve. This is because there is a certain amount of error inherent in curve-fitting the nonlinear standard curve.
For these reasons, various attempts have been made to achieve linear standard curves in sandwich immunoassays which are designed to measure an antigen that is not present in sufficiently low quantity to yield a pseudo first-order reaction under typical assay conditions.
One of the most common approaches to this problem has been to adjust the following two parameters present in the sandwich immunoassay system: (1) the amount of insolubilized first antibody; and/or (2) the amount of labelled second antibody. Specifically, the amount of insolubilized first antibody and/or the amount of labelled second antibody in the immunoassay system is increased pursuant to this approach. By increasing the antibody concentration, the antigen becomes the rate-limiting factor in the system, and a pseudo first-order reaction is created. The adjustment of these parameters is, however, limited in its practical application.
The first parameter concerns the addition of excess insolubilized first antibody to the immunoassay system. However, the amount of antibody which can be insolubilized is necessarily limited by the amount of solid support in the system, often the amount of bead surface, and by the coating method used. In other words, there is a finite limit to the amount of antibody which can be effectively bound to the surface of a given solid support.
The second parameter available for adjustment, under prior art methods, is the addition of excess labelled antibody. This parameter, too, is limited in that the labelled antibody which is added to the system inherently increases the background level of the standard sandwich immunoassay. The background of a system is determined by the measurement obtained when a blank, containing only reagent and none of the substance to be measured, is run in the system. In an immunoassay system, the blank contains no antigen, thus precluding the possibility of the formation of the sandwich complex of insolubilized antibody:antigen:labelled antibody in a sandwich immunoassay.
In an ideal sandwich immunoassay system, there should be no labelled antibody attached to the solid phase when a blank is run, due to the absence of any antibody:antigen:antibody sandwich. Thus, theoretically, one should not be able to detect the presence of label on the insolubilized support. Nevertheless, under the imperfect conditions pursuant to which immunoassays are run, a certain amount of the labelled antibody will be nonspecifically adsorbed directly onto the solid support during the immunoassay. This nonspecific adsorption contributes to an elevated blank reading; i.e., detectable label on the insoluble support which is not related to the formation of the sandwich sought to be measured. Where additional labelled antibody is added to the system, there will be additional nonspecific adsorption and, thus, a higher background level. An increased background level adversely affects the sensitivity of an immunoassay. The prior art addition of excess labelled antibody is, therefore, limited by the amount of increased background the immunoassay system is able to tolerate without suffering a loss of sensitivity.
Yet another approach which has been taken deals with mathematical manipulation of the standard curve in order to achieve a visually linear curve. This is in contrast to the first prior art approach described above wherein the level of antibodies in the system is adjusted in an attempt to achieve an actual linear standard curve. A technique known as logit transformation underlies this second approach. Most simply stated, logit transformation results in a semilogarithmic plot of the relationship between absorbance and antigen quantity. In such a plot, the relationship between absorbance and antigen concentration can be approximated by a linear function, in a limited analytical range, as described by Sorenson, Scand. J. Clin. Lab. Invest., 42, 577-589 (1982).
Linearization by logit transformation is more fully described by Williams et al, J. Immunological Methods, 85, 179-294 (1985). Generally, these procedures require relatively sophisticated computers to perform a least squares solution to the equation represented by the nonlinear standard curve. While a linear approximation of the transformed curve can be made based on this approach and a conversion factor can be calculated from the data, the necessity of running a full standard curve, rather than a single standard, remains.
More recently, Zvaigzne et al., Clin. Chem., 32 (3), 437-440 (1986), developed a procedure wherein the nonlinear standard curve is stored in a computer. Zvaigzne et al. then run a single standard, on the occasion of subsequent assays, in order to update the y-intercept of the transformed nonlinear standard curve. In this respect, Zvaigzne et al. achieve a form of single point calibration in the context of their method. This approach, however, only operates effectively for extremely stable reagent systems. Moreover, the method requires relatively sophisticated computerized equipment, and it cannot completely alleviate a certain amount of error which is inherent in the curve-fitting process.
Accordingly, there is a need for a method of providing an actual linear standard curve in sandwich immunoassays designed to detect and/or measure antigen present in sufficient quantity such that prior art adjustments to the immunoassay system fail to yield a linear standard curve. It is an object of the present invention to provide such a method. It is a further object of the present invention to provide a method for calibrating a standard curve wherein only a single standard need be run, and which single standard can be used to prepare a conversion factor to the absence of sophisticated and/or expensive computerized equipment.